The Blue Cross Blue Shield is a locally owned business that handles health insurance for the citizens of the USA. The business engaged in some arrangements that restricted the competition in the health insurance industry.
Because of this, the Premium Plans were priced higher than they previously were which was problematic for the consumers. In order to correct this error BCBS has agreed to settle in year 2020. Final approval and payment disbursement will begin in the year 2025.
BCBS Lawsuit Settlement:
Blue Cross Blue Shield (BCBS) is an insurance firm that works with healthcare insurance. National alliance but sometimes they work together. Both the firms have their working process and structure. These firms unite to offer insurance to a majority of the society.
All the various plans differ in their various features and possess different charges for each. Previously Blue Cost and Blue Shield operated separately, Blue Cross in offering Hospital Services, and Blue Shield in Physician Services. But now they have merged and operated together for both the services.
The antitrust action against BCBS was a result of allegations that the organization engaged in anti-competitive conduct among its member companies. Specifically, BSBC was alleged to have market partitioning and self-dealing among themselves, which led to Higher Insurance Prices and Lower Reimbursement levels to healthcare providers.
Such actions constitute violations of federal antitrust laws that led to actions by the subscribers and healthcare providers.
Background of Settlement for BCBS Lawsuit:
After some years of litigation, the BCBS settled the antitrust claims. The settlement has two main components, Subscriber Settlement and Provider Settlement. Subscriber Settlement is a $2.67 billion settlement fund to compensate individuals and entities who purchased or were enrolled in BCBS health insurance or administrative service plans from February 2008 to October 2020.
The claimants should have filed their claim on or before November 5, 2021.
The average payment to claimants is projected to cost around $333, although the actual amount is a function of a number of variables, including premiums paid and number of claimants.
Provider Settlement is an additional $2.8 billion payment :
Providers like hospitals, physicians, and other specialty providers who treated BCBS members during the timeframe indicated. Injunctive relief provision is also included in the settlement to promote competition and prevent further Anti-Competitive Activities in the future.
Eligibility for the BCBS Lawsuit Payment:
The eligibility has been divided differently for various individuals. Following are those divisions:
Eligibility for subscribers:
- Time period: Coverage duration under a BCBS health or administrative services plan from February 2008 to October 2020.
- Exclusions: Government accounts and certain self-funded arrangements can be excluded.
- Claims submission: The submission of claims was due on November 5, 2021.
Claim Submission Process:
Claimants can ask for the status of their claims on the settlement website by using their claim number or a special identifier that they were given. In addition, Payments to accepted claimants shall be made via Direct Deposit, Paper Check, PayPal, or Venmo by the payment method indicated when the claim was submitted.
Payment Distribution Schedule:
Distribution of settlement payments involves a multi-step process of dispute resolution, claim adjudication, and payment of funds. Payments to Survivors are expected to be made through mid-2025. The timing will be contingent upon dispute resolution as well as administrative processing. For Providers, with the July 29, 2025 claim filing deadline, payments will start after this date following completion of claim adjudications and appropriation of funds.
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Injunctive Relief Provisions:
Aside from the financial relief, the settlement also has provisions for injunctive relief to encourage competition in the health insurance industry. These are designed to restrain BCBS from doing similar acts in the future in a bid to foster a more competitive market that will lead to better prices and services for consumers and providers alike.
Legal fees and Administrative Costs:
The majority of the settlement funds are used to fund legal and administrative fees. For the settlement of the provider, the attorneys for the plaintiffs requested over $754 million in attorneys’ fees and expenses to compensate for the significant amount of work involved in the legal process that took over ten years.
The BCBS antitrust settlement is a historic healthcare :
litigation settlement that addressed longstanding marketplace competition and fair practice matters. Subscribers and providers who qualify should remain informed about their claim statuses and send in their required documents on time. The settlement is not only about money but also as a precedent to promoting competitive practice in the healthcare industry.
FAQS:
Who would be paid the BCBS settlement amount?
Individuals who have a BCBS healthcare insurance or administrative service plan from 2008 to 2020 may be eligible based on the plan type and claim submitted.
How much money will I get?
They have different payout amounts. The average subscriber payout is approximately $333, but the payout is based on how much you paid in premiums.
